Pharmacy Services

pharmacy searchableCenCal Health Pharmacy Services provides a comprehensive pharmacy benefit that includes formulary management, a robust pharmacy network, and quality customer service. Our pharmacy network spans both Santa Barbara and San Luis Obispo Counties providing our members with convenient pharmacy locations.

Pharmacy Benefit Manager

CenCal Health has contracted with MedImpact as its Pharmacy Benefit Manager (PBM) to assist in the administration of our pharmacy benefit.


MedImpact provides: 

  • Claims processing
  • Pharmacy network management
  • Prior authorizations
  • Customer service
  • Drug utilization management services

CenCal Health Pharmacy Team shall oversee MedImpact’s administrative and daily operational role. To contact MedImpact, call: (800) 788-2949.

Our Promise: Our Pharmacy Team is committed to providing consistent, compassionate, local support.

Opioid Update 2018

CenCal Health Pharmacy Update

2018 Opioid Morphine Equivalent Dose (MED) Limit

CenCal Health and its Pharmacy Benefits Manager (MedImpact), are working together to communicate formulary changes to plan providers. With the approval of CenCal Health's Pharmacy & Therapeutics Committee and in coordination with MedImpact, CenCal Health has begun a Multiphase Implementation Plan to deter over-utilization of opioids, and update utilization management measures. 

Effective 7/1/2018, CenCal Health will be implementing the following MED (Morphine Equivalent Dose) edits to help minimize the over utilization of opioids: 

  • MED (Morphine Equivalent Dose) >120mg

  Soft-Edit at the pharmacy, can be overriden by the pharmacy

  • MED (Morphine Equivalent Dose) >200mg
Hard-Stop at the Pharmacy, Prior Authorization would need to be submitted to justify the MED>200mg

In an effort to minimize disruption to members on Chronic Opioid Therapy, we are notifying providers of the MED limits that will be effective 7/1/2018. For providers with members over the future MED limit, please see the recommended actions below to ensure that there is no disruption in therapy. 

Actions to Take: 
  1. Assess patient and review diagnosis, treatment plan, and possible titration from medications and or willingness to obtain addiction treatment from the County Drug and Alcohol Services Program. 
  • Santa Barbara County: 1-888-868-1649
  • San Luis Obispo County: 1-800-838-1381

    2. If member's medical condition necessitates continuation of therapy above the 200mg MED, the following information must be submitted to obtain Prior Authorization, starting 7/1/2018: 

  • Diagnosis with medical justification 
  • Pain Assessment
  • Urine Screening-Shows concordance with prescriptions
  • Attempts made to titrate therapy
  • Alternative treatment/therapies attempted

Please contact CenCal Health Pharmacy Services Department at (805) 562-1080 if you have any questions. 

Diabetes Formulary Update

SGLT-2 Inhibitor Preferred Agents

Effective 8/1/2018, with the approval of CenCal Health's Pharmacy and Therapeutics Committee, Steglatro and Jardiance will be CenCal Health's preferred SGLT-2 Inhibitors. Segluromet and Synjardy/Synjardy XR will also become the preferred SGLT-2 Inhibitor/Metformin combination products. 

Brand Name Generic Name Strength Formulary Status
Steglatro Ertugliflozin 5mg and 15mg tablets Formulary, QL #30/30ds
Jardiance Empagliflozin 10mg and 25mg tablets Formulary, QL #30/30ds
Segluromet Ertugliflozin/Metformin 2.5-500mg, 2.5-1000mg, 7.5-500mg and 7.5mg-1000mg tablets Formulary, QL #60/30ds
Synjardy Empagliflozin/Metformin 5-500mg, 12.5-500mg, 5-1000mg and 12.5-1000mg tablets Formulary, QL #60/30ds
Synjardy XR Empagliflozin/Metformin 5-1000mg, 10-1000mg, 12.5-1000mg and 25-1000mg tablets Formulary, QL # 60/30ds

In efforts to minimize disruption to CenCal Health providers and members, all current utilization of non-formulary agents will be grandfathered.

For more information on these changes, please contact CenCal Health's Pharmacy Department at (805) 562-1080.

Formulary Updates

DUR: Educational Articles

The purpose of this educational intervention component of DUR is to improve the quality and cost-effectiveness of prescribing and dispensing practices for Medi-Cal recipients. Educational interventions include ongoing dissemination of information through the Medi-Cal provider bulleting process about clinically important, drug-specific therapy problems. 

Drug Safety Communication Adverse Effects from Fluoroquinolone Antibiotics-July 2018

ProDUR Update Additive Toxicity Alert Now Focused Only On CNS Depressants

In the Pharmacy: Pharmacist Furnishing Nicotine Replacement Products

Drug Safety Communication: New Age Limit of Opioid Cough and Cold Medicines-February 2018

2017 Immunization Updates: Influenza, HepA, Meningococcal, HPV, Adult Vaccines-September 2017

Clinical Review: Drug-Induces QT Interval Prolongation-August 2017